OBJECTIVES 1- To describe a new technique for performing retrograde sonourethrography (RSUG), using the clamp method of urethrography. 2- To describe a new technique for performing sonourethrography with contrast-enhancemet, both retrograde (CE-RSUG) and voiding (CE-VSUG). 3- To compare the capacity of detection of anterior urethral stenosis of retrograde urethrography (RUG), RSUG and CE-RSUG. 4- To compare the capacity of detection of posterior urethral stenosis of voiding cystourethrography (VCUG) and CE-VSUG. MATERIAL AND METHODS 1. Patients Between September 2011 and June 2015, 120 patients with urethral stricture confirmed by urethrography were admitted, of whom 7 were excluded (2 cases with paraplegia, 4 cases with urethrocystoscopy between the two techniques and one case with phimosis). Finally, 113 males were included (mean age: 55 ± 15 (SD) years; range, 14-86 years), who underwent sonourethrography using the clamp method. 2. Retrograde sonourethrography (RSUG) An ACUSON S2000 (Siemens Healthcare, Erlangen, Germany) were used. The lineal probe (8-12 MHz) was employed for RSUG. 6 or 10 Fr prelubricated urethral catheters were used (SpeediCath; Coloplast, Humlebæk, Denmark). The catheter was connected to a bottle of saline solution (with infusion system) and coupled to the Berna Ring (DVIMAG, Alicante, Spain). RSUG was performed using the clamp method of urethrography. 3. Sonourethrography with contrast-enhancemet The connector joining the 500 ml bottle of saline solution to the catheter was fitted with a triple port for syringe injection of sonographic contrast once the anterior urethra was visualised with saline solution, and saline solution flow was then resumed until the bladder was filled retrogradely (CE-RSUG). Each patient had two vials (10 ml) of sulphur hexafluoride (SonoVue; Bracco, Milan, Italy). The bladder neck and the posterior urethra were visualized transperineally during voiding study (CE-VSUG). 4. Statistical Analysis Statistical analysis was performed by using software SPSS 17.0 version (Chicago: SPSS Inc). A descriptive analysis of all the variables was performed by determining the frequency distribution; we calculated the characteristic parameters of the quantitative variables (mean, standard deviation, maximum, and minimum). To compare qualitative variables McNemar test was used. P < 0 .05 was considered to indicate a statistically signiﬁcant difference. CONCLUSIONS 1. The new technique of RSUG using the clamp method is a simple, effective and well tolerated procedure by the patient. It allows performing the technique in the difficult cases of uretromeatal anomalies (stenosis, hypospadias, meatotomy) that cannot be carried out with the Foley catheter. 2. The new technique of contrast-enhancement sonourethrography allows the anterior and posterior urethra to be evaluated in a simple and effective way. It is possible to visualize transperineally the well-opacified posterior urethra with contrast during voiding. 3. RSUG had a greater capacity than RUG to detect anterior urethral stenosis, especially those located in the proximal bulbar urethra. RSUG and CE-RSUG had the same capacity to detect anterior urethral stenosis. 4. CE-VSUG had a greater capacity than VCUG to detect posterior urethral stenosis, especially those located in the bladder neck.